Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain.
Endocrinology and Nutrition Department, Health Sciences Research Institute and University, Hospital Germans Trias i Pujol, Badalona, Spain.
J Diabetes Sci Technol. 2023 Sep;17(5):1326-1336. doi: 10.1177/19322968221088601. Epub 2022 Apr 26.
New metrics for assessing glycemic control beyond HbA1c have recently emerged due to the increasing use of continuous glucose monitoring (CGM) in diabetes clinical practice. Among them, time in range (TIR) has appeared as a simple and intuitive metric that correlates inversely with HbA1c and has also been newly linked to the risk of long-term diabetes complications. The International Consensus on Time in Range established a series of target glucose ranges (TIR, time below range and time above range) and recommendations for time spent within these ranges for different diabetes populations. These parameters should be evaluated together with the ambulatory glucose profile (AGP). Using standardized visual reporting may help people with diabetes and healthcare professionals in the evaluation of glucose control in frequent clinical situations. The objective of the present review is to provide practical insights to quick interpretation of patient-centered metrics based on flash glucose monitoring data, as well as showing some visual examples of common clinical situations and giving practical recommendations for their management.
由于连续血糖监测(CGM)在糖尿病临床实践中的广泛应用,目前已经出现了一些新的评估血糖控制的指标,不仅可以超越糖化血红蛋白(HbA1c)的评估。其中,血糖达标时间(TIR)作为一种简单直观的指标,与 HbA1c 呈负相关,并且与长期糖尿病并发症的风险也有新的关联。国际 TIR 共识制定了一系列目标血糖范围(TIR、血糖低于目标范围和血糖高于目标范围)和不同糖尿病人群的目标范围内时间的建议。这些参数应与动态血糖谱(AGP)一起评估。使用标准化的可视报告可能有助于糖尿病患者和医疗保健专业人员在频繁的临床情况下评估血糖控制情况。本综述的目的是为基于瞬态血糖监测数据的患者为中心指标的快速解读提供实用的见解,并展示一些常见临床情况的可视化示例,并给出管理这些情况的实用建议。